Whether British teenagers enjoy and feel that they have learned from sexuality education partly depends on how and by whom the material is taught.1 Significantly greater proportions of adolescents who have received sexuality education from peer educators than of those who have been in programs led by teachers report that the sessions changed their views on sexual matters (31% vs. 27%), were relevant to their experiences (44% vs. 37%) and were enjoyable (51% vs. 33%); a smaller proportion of students who have had peer-led instruction than of others report not having heard anything new (27% vs. 46%). On the other hand, a greater proportion of students who have received teacher-led education than of those who have had peer-led instruction report that their sessions were well controlled (69% vs. 62%).

To investigate students' views on sexuality education, researchers used data from a 1998-1999 survey of year 10 students (14-15-year-olds) who attended schools in central southern England that were randomly selected to provide either teacher-led (13 schools) or peer-led sexuality education (14 schools). The questionnaire inquired about students' demographic characteristics; their sexual knowledge, attitudes and behaviors; and their experiences with and evaluation of their year nine sexuality education programs, which were taught either by teachers or by specially trained year 12 peer educators (16-17-year-olds). The analyses are based on responses of 7,700 students.

The researchers also utilized qualitative data drawn from 52 focus-group discussions with year nine students: 41 in the schools that had peer-led sexuality education and 11 in those with teacher-led programs. Each focus group consisted of 6-8 teenagers led by one researcher; single-sex discussions were held when possible. Students were guaranteed that their anonymity would be protected and that their comments would be kept confidential.

To analyze the survey data, the researchers compared the frequencies of responses by type of program and students' gender. Using logistic regression analysis, they measured the effects of these factors and the interaction between them. The researchers analyzed the focus-group data by coding them with thematic headings and comparing responses across groups.

During their sexuality education sessions, significantly greater proportions of adolescents in peer-led programs than in teacher-led programs had looked at contraceptives (94% vs. 71%), touched condoms (87% vs. 29%), taken handouts (76% vs. 66%), had opportunities to ask questions (93% vs. 89%) and worked in small groups (97% vs. 72%). In addition, greater proportions of students taught by peers reported that the sessions changed their views on sexual matters (31% vs. 27%), were relevant to their experiences (44% vs. 37%), would be relevant in the future (67% vs. 59%) and were enjoyable (51% vs. 33%); a smaller proportion reported not hearing anything new (27% vs. 46%). Furthermore, teenagers who had received peer-led sexuality education were more likely than others to have asked questions and joined in the discussions, and to think that the sessions were good for students of both sexes and that the person teaching the session knew a lot about the subject.

By contrast, students in teacher-led programs were more likely than those who had been in peer-led programs to report that their sessions had been well controlled (69% vs. 62%), and less likely to report that the person leading the class had gotten embarrassed (11% vs. 22%) and that some people in the class had not been involved (45% vs. 52%). All of the differences by type of program were statistically significant once gender was controlled for in the logistic regression analysis.

In analyses taking type of program into account, young men were significantly more likely than women to report that they had taken handouts, asked questions and joined in discussions, and that the sessions changed their views on sexual matters, were relevant to their own experiences, were enjoyable, were good for men and were well controlled (odds ratios, 1.1-2.4). They were less likely than young women to say that they had felt uncomfortable during the sessions and that sexuality education was good for women (0.8-0.9).

Some significant interactions were present between gender and type of sexuality education. Although students from peer-led programs were more likely than others to have asked questions and joined in discussions, the difference was significantly greater for young men than for young women. In addition, women who had received peer-led sexuality education were more likely than men from peer-led programs to report not having heard anything new. Furthermore, although the overall proportion of students who reported that people had misbehaved during the sessions did not differ by type of program, a greater proportion of males than females in teacher-led programs and a greater proportion of females than males in peer-led programs reported this.

During the focus groups, students expressed greater satisfaction with peer-led sexuality education than with teacher-led programs. Students seemed to respond more positively to hands-on and "active-learning" methods, predominantly used by peer educators, than to teachers' lectures. Furthermore, students believed that peer educators were more empathic, open and trustworthy, and less judgmental than teachers. And although students reported that teachers were better able to manage and control sessions, they felt that the increased background noise in peer-led sessions allowed them to participate without feeling like the center of attention.

The researchers caution that although the data suggest that peer-led sexuality education has certain advantages over teacher-led programs, some of the students' enthusiasm for peer education may reflect that the methods are seen as "subversive of the normal teacher-student relationship." Furthermore, sizable proportions of adolescents in both peer- and teacher-led programs reported that the sexuality education sessions were not enjoyable or not relevant to their experiences. The researchers conclude that sexuality education "needs to be sustained and reiterated at increasing levels of complexity as young people grow older."--J. Rosenberg